Tuesday, December 19, 2017

State reports eligibility review cut 80,000 from Medicaid rolls

The state Department of Human Services said today that it had cut 80,000 people from Medicaid rolls in an eligibility review. From the state release:

“At the beginning of 2017, we’d finally processed the last of a backlog of over 140,000 Medicaid eligibility cases. With a backlog that big, we knew there had to be inaccuracies on the rolls so cleaning that up became our focus,” said DHS Director Cindy Gillespie. “I’m proud to say that our Division of County Operations staff jumped right in on this accuracy project, and we’ve had tremendous results.”

The six focus areas included:

Working with the Department of Workforce Services to capture unreported employment. That resulted in 16,467 cases being closed.

Identifying individuals receiving public benefits from more than one state, which resulted in 25,742 cases being closed.

Establishing a process to sort large volumes of returned mail due to bad addresses. That resulted in 26,093 cases being closed because beneficiaries are required to report change of address so that DHS can ensure they remain in state.

Identifying those on Medicaid now eligible for Medicare, which resulted in 7,198 cases being closed because Arkansas Works enrollees cannot have both Medicare and Medicaid.

Removal of individuals incarcerated by the Department of Corrections from the rolls because inmates are generally not eligible for Medicaid. That resulted in 4,131 cases being closed. DHS worked with Corrections to create real-time access to incarceration data after the Office of Medicaid Inspector General found that some inmates remained on the Medicaid rolls after they were incarcerated.

Working with various carriers to identify those over the federal poverty level limits with coverage through Arkansas Works and the federal marketplace. That resulted in 762 cases being closed.

Gov. Asa Hutchinson cheered the cost-cutting effort and DHS promised continuation of such oversight next year.

Another change planned next year is Electronic Visit Verification. It's a phone app by which Medicaid-paid aides check in at a home to provide services. The app will record the location and the amount of time spent there and match that with claims data.

An Arkansas anti-abortion law is a phony. It's about ending abortion, not protecting women and a New York Times writer says it could present an important case for the U.S. Supreme Court.

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